CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: Banner Goldfield Medical Center

Billing Code: 451 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 451
Insurance Median: $25,180
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Spinal fusion, single level (inpatient stay) at Banner Goldfield Medical Center is $25,180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $23,503.93, this hospital’s rate is 1.07x the Medicare baseline. Located in 2050 West Southern Avenue, Apache Junction, AZ.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$25,180

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$23,503.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $23,503.93 (100%)

Insurance Median: $25,180 (107%)

Ins. Median: $25,180 (107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $23,503.93 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$25,180 - $78,202	107%
Arizona Physicians Ipa	$25,180	107%
Banner Health	$25,180	107%
Banner University Health Plan	$25,180	107%
Blue Cross Blue Shield	$25,180	107%
Care 1St	$25,180	107%
Cigna	$25,180 - $93,398	107%
Gila River Health Care Corporation	$25,180	107%
Health Choice Arizona, Inc.	$25,180 - $37,770	107%
Health Net	$25,180 - $37,267	107%
Humana	$25,180 - $25,936	107%
Kaiser Foundation Health Plan	$25,180	107%
Mercy Care	$25,180	107%
Triwest Healthcare Alliance Corp - Va Ccn	$25,180	107%
UnitedHealthcare	$25,180 - $81,835	107%
Upmc Health Plan	$25,180	107%
Wellpoint	$25,180	107%
Carelon	$26,439	112%
Devoted Health Services	$26,439	112%
Arizona Priority Care	$27,698	118%
Gold Kidney Health Plan	$27,698	118%
Oscar Health Plan	$37,770	161%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 451.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner Goldfield Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 451.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.